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If you file an on-line complaint form, it will be transmitted to the ACLU of Kansas and Western Missouri (hereafter the ACLU) by unencrypted e-mail. Unencrypted e-mail communication may not be a secure method of communication. The main point at which unencrypted e-mail communication may not be secure is on the sender's (your) end. Specifically, if you are using a public or shared computer to send an e-mail to the ACLU, your messages may be available to anyone else who has access to that computer. You should take precautions to prevent other people from accessing your private or confidential e-mails on your end. There is also a small but still real risk that your e-mail message could be intercepted or stored as it passes through e-mail servers on its delivery route to the ACLU. Once any on-line complaint form you send arrives at the ACLU, only authorized members of the ACLU's Legal Department will have access to your complaint. In accordance with the applicable lawyer ethics rules, any information you share with us will be protected as confidential and will not be shared with people outside the ACLU's Legal Department without your authorization. The ACLU recommends against including in your on-line complaint highly sensitive information such as Social Security numbers. If you are concerned about the security of your e-mail, you should download a complaint form and mail it to the ACLU.

I understand that this on-line complaint form will be transmitted to the ACLU by unencrypted e-mail. I also acknowledge that the ACLU has warned me that unencrypted e-mail communication may not be a secure method of communication.

I understand that, by receiving this complaint, the ACLU is not agreeing to represent me in any currently pending or future lawsuit or legal proceeding of any kind. Moreover, I understand and agree that the ACLU is not responsible for ensuring that any statute of limitations requirements are met in my case or that any court deadlines are met in any currently pending case or other legal proceeding I may have. I further understand that the ACLU will not be representing me unless and until both a representative of the ACLU and I have signed a written Client Retainer Agreement prepared by a lawyer affiliated with the ACLU. Until such an Agreement has been signed, the ACLU will only be assessing and investigating whether or not it can provide me with representation or other assistance.

I hereby authorize the ACLU to use the information I have provided to the ACLU as necessary to determine whether it will offer me legal or other assistance. I specifically authorize the ACLU to use my name in its investigation of this complaint, including in contacts with the government or other entity about which I have complained.

In addition, after the conclusion of the investigation, I grant permission to the ACLU to transfer to the ACLU archives (currently housed at the Western Missouri Historical Manuscripts Collection on the campus of the University of Missouri at Kansas City) my entire ACLU file. However, the following materials will be protected from public disclosure: (1) private medical records of the client or other individuals involved in the complaint; (2) private financial records (including social security numbers) of the client or other individuals involved in the complaint; and (3) information about the client or other individuals involved in the complaint that would cause extreme embarrassment or humiliation if disclosed to the public. By signing this complaint form, I specifically transfer any property right that I have in my complaint file to the ACLU, the ACLU archives, and the Western Missouri Historical Manuscripts Collection.